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用于确定炎症性肠病的新型统计方法:患者对共同决策的看法。

Novel Statistical Approach to Determine Inflammatory Bowel Disease: Patients' Perspectives on Shared Decision Making.

作者信息

Siegel Corey A, Lofland Jennifer H, Naim Ahmad, Gollins Jan, Walls Danielle M, Rudder Laura E, Reynolds Chuck

机构信息

Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, 850 Ridgeview Drive, Horsham, PA, 19044, USA.

出版信息

Patient. 2016 Feb;9(1):79-89. doi: 10.1007/s40271-015-0126-z.

Abstract

BACKGROUND

Limited information is available on patients' perspectives of shared decision-making practices used in inflammatory bowel disease (IBD).

OBJECTIVE

The aim of this study was to examine patient insights regarding shared decision making among patients with IBD using novel statistical technology to analyze qualitative data.

METHODS

Two 10-patient focus groups (10 ulcerative colitis patients and 10 Crohn's disease patients) were conducted in Chicago in January 2012 to explore patients' experiences, concerns, and preferences related to shared decision making. Key audio excerpts of focus group insights were embedded within a 25-min online patient survey and used for moment-to-moment affect trace analysis.

RESULTS

A total of 355 IBD patients completed the survey (ulcerative colitis 51 %; Crohn's disease 49 %; female 54 %; 18-50 years of age 50 %). The majority of patients (66 %) reported increased satisfaction when they participated in shared decision making. Three unique patient clusters were identified based on their involvement in shared decision making: satisfied, content, and dissatisfied. Satisfied patients (18 %) had a positive physician relationship and a high level of trust with their physician. Content patients (48 %) had a moderate level of trust with their physician. Dissatisfied patients (34 %) had a life greatly affected by IBD, a low level of trust of their physician, a negative relationship with their physician, were skeptical of decisions, and did not rely on their physician for assistance.

CONCLUSION

This study provides valuable insights regarding patients' perceptions of the shared decision-making process in IBD treatment using a novel moment-to-moment hybrid technology approach. Patient perspectives in this study indicate an increased desire for shared decision making in determining an optimal IBD treatment plan.

摘要

背景

关于炎症性肠病(IBD)患者对共同决策实践的看法,目前可用信息有限。

目的

本研究旨在使用新颖的统计技术分析定性数据,以考察IBD患者对共同决策的见解。

方法

2012年1月在芝加哥进行了两个每组10名患者的焦点小组(10名溃疡性结肠炎患者和10名克罗恩病患者),以探讨患者与共同决策相关的经历、担忧和偏好。焦点小组见解的关键音频摘录被嵌入到一个25分钟的在线患者调查中,并用于即时情感追踪分析。

结果

共有355名IBD患者完成了调查(溃疡性结肠炎患者占51%;克罗恩病患者占49%;女性占54%;年龄在18 - 50岁之间的占50%)。大多数患者(66%)表示参与共同决策时满意度增加。根据患者参与共同决策的情况,确定了三个独特的患者群体:满意、满足和不满意。满意的患者(18%)与医生关系良好且高度信任医生。满足的患者(48%)对医生有中等程度的信任。不满意的患者(34%)的生活受到IBD的极大影响,对医生的信任度低,与医生关系消极,对决策持怀疑态度,且不依赖医生提供帮助。

结论

本研究使用新颖的即时混合技术方法,提供了关于患者对IBD治疗中共同决策过程看法的宝贵见解。本研究中的患者观点表明,在确定最佳IBD治疗方案时,对共同决策的需求增加。

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